Oral contraceptives and myocardial infarction: new evidence leaves unanswered questions
Thorogood, M.
Thrombosis and Haemostasis 78(1): 334-338
1997
ISSN/ISBN: 0340-6245 PMID: 9198175 Document Number: 477900
Early epidemiologic studies indicated that current use of oral contraceptives (OCs) was associated with a 2- to 4-fold increase in the risk of myocardial infarction. Recent reductions in the estrogen dose of OC formulations and more cautious prescribing practices have reduced this risk to below 2-fold. Although sufficient evidence has not been accumulated, there are preliminary indications that third-generation OCs containing desogestrel or gestodene confer no increased risk of myocardial infarction. Studies examining the risk of past OC use of at least 5 years' duration have produced conflicting results. Since myocardial infarction is rare among young women, especially in the absence of cigarette smoking and clinical risk factors, the population attributable risk may be less than 3 events in 1 million woman-years.